Microsurgical treatment for patients with fenestrated anterior communicating artery aneurysms.

OBJECTIVE: The purpose of this study was to investigate the imaging characteristics of fenestrated AcomA aneurysm and clinical outcome of patients with fenestrated AcomA aneurysm.

METHODS: We performed a retrospective study of consecutive patients with AcomA aneurysms between January 2013 and December 2017. According to the vascular variations of the AcomA, the patients were divided into two groups: fenestrated AcomA aneurysms and non-fenestrated AcomA aneurysms. Baseline characteristics, clinical complications and outcomes of patients were analyzed.

RESULTS: A total of 217 patients with AcomA aneurysms were included in this study. Compared with non-fenestrated AcomA aneurysms, the size of fenestrated AcomA aneurysms was significantly smaller (P<0.001). Besides, the patients with fenestrated AcomA aneurysms had higher rate of rebleeding (P=0.036), hydrocephalus (P=0.017), delayed cerebral ischemia (P=0.021) and pulmonary infection (P=0.017) than those with non-fenestrated AcomA aneurysms. According to Glasgow Outcome Scale at follow-up, the patients with fenestrated AcomA aneurysms had higher rate of disability (P=0.035) (GOS 2-3) and mortality (P=0.013) (GOS 1).

CONCLUSIONS: Fenestrated AcomA aneurysms are associated with higher clinical complications, and identification of AcomA fenestration contributes to successful clipping of AcomA aneurysms.